Background: Ankylosing spondylitis is an inflammatory disease and leading case of back pain worldwide. It is thought that the gene human leukocyte antigen-B27 (HLA-B27) provides a strong tendency in people to develop ankylosing spondylitis. This study was designed to evaluate the frequency of HLA-B27 among patients with ankylosing spondylitis and clinical manifestation among the HLA-B27 positive and negative patients. Methods: A cross-sectional study was done in the Department of Medicine and Department Rheumatology of BSMMU, Shahbag, Dhaka, Bangladesh from 1st January 2016 to 30th June 2016. Results: Total 70 patients were included in this study, among those 54 were male and 16 were female and total 54 patients (77.14%) were HLA-B27 positive and 16 patients (22.86%) were HLA-B27 negative. Most HLAB27 positive patients had extra-articular manifestation, family history of low back pain and high level of BASDAI score, compared to those who were negative. Among the 54 positive patients, 9 (16.67%) had combination of tendinitis, enthesitis and uveitis and 2 (3.70%) had all four of extra-articular manifestation. Among the 16 negative patients, 2 (12.5%) had all four extra-articular manifestation. Among 16 negative patients 9 (56.25%) had raised erythrocyte sedimentation rate (ESR) and 5 (31.25%) had raised C-reactive protein (CRP). On the other hand, among 54 positive patients 48 (88.89%) had raised ESR and 44 (81.48%) had raised CRP. Conclusion: The association of HLA-B27 might be the reason of disease severity among the positive patients. Birdem Med J 2019; 9(3): 188-192
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may be succeeded by a spectrum of complications, including invasive fungal infections (IFIs). Here, we describe a case of rhino-orbital mucormycosis in a recovered coronavirus disease-19 (COVID-19) patient with underlying non-Hodgkin's lymphoma (NHL). Our patient was normotensive, non-diabetic, presenting with multiple non-healing ulcers on different parts of the body. She received high-dose glucocorticoids and antibiotics during her severe COVID-19 illness. Three weeks following COVID-19 detection, she developed progressive rhino-orbital lesion with profuse pus formation, along with pain and redness of the left eye. Histopathology from the lesion revealed mucormycosis. She was treated with Amphotericin B. Unfortunately, the patient died after the first cycle of chemotherapy for NHL. Due to the high chance of mortality, timely clinical suspicion along with microbiological diagnosis is necessary for the early detection of infection. Strong policymaking should also be implicated to revisit the cost effectiveness of available treatments to reduce case fatality.
Bangladesh is an example of a highly populous, agricultural country where melioidosis may be a significantly under diagnosed cause of infection and death. A recent regression model predicted 16,931 cases annually in Bangladesh with a mortality rate of 56%. However, we only manage to confirm (culture) around 80 cases in last 60 years. A lack of awareness among microbiologists and clinicians and a lack of diagnostic microbiology infrastructure are factors that are likely to lead to the underreporting of melioidosis. Melioidosis transmits through inoculation, inhalation and ingestion. Diabetes mellitus is the most common risk factor (12 times higher chance of getting the infection) predisposing individuals to melioidosis and is present in >50% of all patients. The clinical presentation is widely varied and can be mistaken for other diseases such as tuberculosis or more common forms of pneumonia giving rise to its nickname as the “great mimicker”. Disease manifestations vary from pneumonia or localized abscess to acute septicemias, or may present as a chronic infection. Culture is considered the current gold-standard for diagnosis and culture-confirmation should always be sought in patients where disease is suspected. It is strongly recommended that any non–Pseudomonas aeruginosa, oxidase-positive, Gram-negative bacillus isolated from any clinical specimen from a patient in an endemic area should be suspected to be Burkholderia pseudomallei (BP). In addition, based on antibiogram, any Gramnegative bacilli that are oxidase-positive, typically resistant to aminoglycosides (e.g., gentamicin), colistin, and polymyxin but sensitive to amoxicillin/clavulanic acid should be considered as BP. This bacteria is inherently resistant to penicillin, ampicillin, first generation and second-generation cephalosporins, gentamicin, tobramycin, streptomycin, and polymyxin. For intensive phase (10 to 14 days), ceftazidime or carbapenem is the drug of choice. For eradication phase (3 to 6 months), oral trimethoprim/ sulfamethoxazole is the drug of choice. Surgery (drainage of abscess) has an important role in the management of melioidosis. Preventive measures through protective gears could be useful particularly for the risk groups. J MEDICINE 2021; 22: 139-145
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.